It’s not because they are skeptical in the colloquial sense. Rather, the term refers to the philosophy of skepticism. According to Wikipedia:

Philosophical skepticism is an overall approach that requires all information to be well supported by evidence…

In philosophy, skepticism refers more specifically to any one of several propositions. These include propositions about:

(a) an inquiry,
(b) a method of obtaining knowledge through systematic doubt and continual testing,
(c) the arbitrariness, relativity, or subjectivity of moral values,
(d) the limitations of knowledge,
(e) a method of intellectual caution and suspended judgment.

Why aren’t those who are skeptical of scientific consensus on issues like vaccines and evolution skeptics? They are denialists as Andrew Dart explains in an chapter from Building your Skeptical Toolkit:

… [T]here are a lot of people who like to call themselves skeptics but who it can be strongly argued are anything but. There’s HIV/AIDS skeptics, global warming skeptics, moon landing skeptics, evolution skeptics, holocaust skeptics, 9/11 skeptics and vaccination skeptics, to name but a few. But while there may be some people who would use these labels who could legitimately be described as skeptics the vast majority of them are not practicing skepticism at all, but rather skepticism’s evil twin, denialism.

What’s the difference between skeptics and denialists?

Denialism … is driven by ideology rather than evidence. Now denialists may claim they care about the evidence and will happily display any that supports their point of view, but in most cases they reject far more evidence than they accept. Furthermore, denialists will cling to evidence no matter how many times they have been shown that it is flawed, incorrect or that it does not support their conclusions; the same old arguments just come up again and again. Denialism also tends to focus on trying to generate a controversy surrounding the subject at hand, often in the public rather than scientific arena, and does so more often than not by denying that a scientific consensus on the matter even exists.

It’s easy to see how vaccine rejectionists and creationists are denialists. Though it isn’t as obvious, natural childbirth and homebirth advocates are denialists, too. They deny the scientific consensus of modern obstetrics. And natural childbirth and homebirth advocates share key attitudes with vaccine rejectionists, creationists and other denialists.

1. Denialists love of conspiracy theories.

As Dart explains:

So the vast majority of the scientific community and an overwhelming mountain of evidence is aligned against you, what are you going to do? Well you could always claim that there is a conspiracy to supress the truth and that the scientists working in the field are engaged in a complex cover up for some bizarre and often undefined reason…

Vaccine rejectionists are blunt about their favorite conspiracy: Big Pharma is in cahoots with Big Medicine to make money from useless and/or harmful vaccines.

Natural childbirth and homebirth advocates do include some blunt conspiracy theories like the idea that C-sections occur because obstetricians want to get to their golf games, but professional NCB and homebirth advocates are more subtle. They assert an acculturation conspiracy, whereby doctors are “socialized” to participate in the conspiracy to foist harmful/scientifically unsubstantiated practices on women.

Most scientists are viewed as simply towing the party line and it is assumed that none of them ever comes to their own conclusions based upon the evidence; they just believe what they are told to believe. As for the peer review process, well that is just a tool of the conspiracy to make sure that only those papers that agree with the conspirator’s message get published.

Conspiracy theories, whether blunt or subtle are nothing more than evasions.

These conspiracy theories never attempt to actually address the evidence; rather they seek to dismiss it entirely as a fabrication of unseen forces. Furthermore no explanation as to how a conspiracy so vast that it encompasses every scientist in a given field, as well as every student studying to become a scientist in that field, can maintain itself without someone blowing the whistle is ever given, and reasons why the conspiracies exist in the first place are equally rare and incoherent.

2. Denialists love fake experts.

Fake experts are defined as people who claim to be experts in a given field but whose opinions differ greatly from the consensus of scientists working in that field and from
established knowledge…

NCB and homebirth advocacy are filled with fake, self-appointed “experts,” like Henci Goer who has no training in obstetrics, midwifery or statistics or Barbara Harper who cheerfully acknowledges that her entire career promoting waterbirth is based on an article she read in the National Enquirer.

3. Denialists love cherry-picking.

Cherry picking is the act of selecting papers and evidence that seem to support your point of view, whilst at the same time ignoring the far greater body of evidence that goes against
your position.

NCB and homebirth advocates make cherry-picking even easier than usual since they don’t even bother to read the articles they cite.

4. Denialists love impossible expectations

Hence the insistence by vaccine rejectionists that we don’t know if vaccines are effective if we don’t have a randomized controlled trial of vaccines vs. placebo, an experiment that would be unethical. The latest garbage on homebirth from the Cochrane Review falls into the same category; the authors make the absurd claim that in the absence of randomized controlled trials of homebirth means that there is no evidence that hospital birth is safer than homebirth.

Dart’s conclusion is one that anyone who cares about scientific integrity should keep in mind:

It is not the topic that makes someone a skeptic or a denier, it is how they handle evidence that contradicts their pre-existing beliefs. Do they resort to claiming there is a conspiracy to suppress the truth in order to explain why the evidence is against them? Are the people presenting the argument actually experts in the topic at hand? Do they cherry pick the data and only present those findings that agree with them? And do they constantly move the goalposts and make use of logical fallacies in defense of their claims? If you keep a look out for these five things then you should have a good idea whether you are dealing with a genuine skeptic or a closed minded denier.

“Tuteur quotes Dart’s discussion of conspiracy theories, then uses an
unexplained, idiosyncratic definition of “conspiracy theory” to assert
that natural childbirth advocates are conspiracy theorists. Under her
implicit redefinition of “conspiracy theory,” anyone who acknowledges
unconscious bias (such as the possibility that a doctor might intervene
quicker if he wants to get to a golf game) is evoking a conspiracy
theory.”

Doctors do C-sections because they want to get to their golf games? That’s a conspiracy theory. QED!

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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